1976 Ft. Dix swine flu outbreak offers guidance

May 10, 2009 — ssgtlanger

By Marie McCullough, Inquirer Staff Writer

The mysterious 1976 swine flu outbreak at Fort Dix and the vaccination program that followed are sure to influence the way public health officials respond to the current potential pandemic. David J. Sencer hopes his searing experience “could help guide decisions.”

Sencer, a Harvard-educated public health expert, was fired as director of the U.S. Centers for Disease Control after the 1976 outbreak failed to turn into a pandemic – and the vaccine program turned into disaster. The shot was linked to 500 cases of Guillain-Barre syndrome, including at least 25 related deaths, while the swine flu killed only one of the 230 soldiers it sickened.

Sencer reflected on that 1976 emergency in an article published in the journal Emerging Infectious Diseases in 2006 – amid fears that avian flu would become a pandemic. He remained convinced that his recommendation to hastily ramp up swine flu vaccine production and inoculate the entire country was prudent. His advice was seconded by CDC vaccine advisers, accepted by then-President Gerald R. Ford, and authorized by congressional legislation that provided funding.

“Because of the unpredictability of influenza, responsible public health leaders must be willing to take risks on behalf of the public,” Sencer wrote with a colleague. “This requires personal courage and a reasonable level of understanding by the politicians.” Richard Hodder, 68, one of the Army epidemiologists who investigated the Fort Dix outbreak, thought then that vaccine should be made but stockpiled, and not immediately used. Russia was among countries that stockpiled vaccine after it was made.

Even so, Hodder says now that Sencer was unfairly blamed for the unforeseeable. “Generals and doctors have the same problem: They have to make a decision today with the information they have,” said Hodder, who is retired and lives in Hawthorne, N.Y. Numerous considerations shaped his recommendation, Sencer wrote.

For one thing, the 1918 pandemic that killed millions was believed to have been a swine flu. For another, an unusual opportunity existed in 1976 because the Fort Dix outbreak occurred in February, giving vaccine-makers just enough time to make swine flu vaccine before launching seasonal flu vaccine production. In addition, if swine flu broke out in the general population, “the disease would spread faster than any ability to mobilize preventive efforts,” Sencer wrote.